Compliance may be the single most important factor in assuring a successful treatment outcome. Compliance is when the individual's behavior coincides with medical recommendations. The extent to which individuals comply can vary greatly. In fact, compliance may not be an all-or-none behavior. Most patients are compliant during the start of drug treatment but eventually begin missing doses. Some patients may be only be compliant with certain drugs that they feel benefits them, and non-compliant with medications that are unpleasant to take or they feel are not helping them.

The elderly are commonly perceived as having difficulty with compliance. Most investigations, however, have found the relationship between compliance and age to be inconsistent. Elderly patients may have more difficulty complying with medication regimens because of increased medication use, chronic illnesses, isolated living situations, decreased mobility, and limited incomes. However, memory loss or forgetfulness has not been found to play as large a role in noncompliance as one might commonly perceive.

Patients who understand their illness and their medications are more likely to comply. Patients who have a good relationship with their primary care providers are also more likely to comply. Health care providers can promote compliance by involving the patient in a partnership-type relationship, making the patient feel responsible for aspects of their care. Reducing the complexity of the medication regimen is also an important aspect in improving compliance. Regimens requiring medications to be taken more than twice a day are more likely to result in noncompliance.

The elderly patient should be counseled regarding his/her disease state and medications. Educational video- and audio- tapes are available for patients to listen to at home. Assessment for vision and hearing impairment should be done routinely. Older persons with hearing impairment should be spoken to in a lower voice with more volume. Written instructions with large print should be utilized, when possible. Compliance aids such as a dosing calendar or a pillbox may be helpful to remind the patient to take the medication.

Different colored vial caps are useful to help distinguish medications. Easy open caps are also available for patients with arthritis. Remember that early investment in patient education can have lasting benefits for the patient in terms of their health outcomes.